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California rates for HCPCS 28103

Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $7,585.78 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $446.68 / $2,137.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $8,511.38 / $15,848.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $676.08 / $1,258.93
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $4,168.69 / $11,481.54
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $602.56 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $10,232.93 / $10,232.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $537.03 / $1,047.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $426.58 / $575.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $457.09 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,512.09 / $29,512.09 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $537.03 / $831.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $549.54 / $1,023.29
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $489.78 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,762.47 / $14,125.38 / $28,840.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $436.52 / $870.96